Membership Form

CJSOLogo 14Aug12

Canada Japan Society of Ottawa

Name: _____________________________________
_____ same as on file or



_____ same as now listed or
Home:   __________________________
Office:   __________________________

Email address:  __________________________________

Please check type of membership desired:
New_______ or
Renewal ____

_____ Individual, $10
_____ Family, $25
_____ Student Visa or Work/ Holiday Visa (no charge).
If family membership, please list family members and indicate ages of children under 16:

CJSO Reminder/ Confirmation of Attendance at Monthly Events (Please check one only):
Contact me by e-mail: _____
Contact me by phone: _____

Please do not send cash by mail. Make your cheque or money order payable to:
Canada Japan Society of Ottawa
2823 Mozart Court
Ottawa, ON K1T 2P6

And, Thank you very much for Coming In!